FOX CHASE CANCER CENTER MEDICAL GROUP, INC (NPI# 1457625535) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457625535 |
| Entity Type | Organization |
| Organization Name | FOX CHASE CANCER CENTER MEDICAL GROUP, INC |
| Other Organization Name | OTOLARYN ASSOC OF FCCC, MGI |
| Practice Address |
333 Cottman Ave Fox Chase Cancer Center Philadelphia PA 19111-2434 |
| Mailing Address |
2450 W Hunting Park Ave Philadelphia PA 19129-1302 |
| Practice Telephone | 2157286900 |
| Practice Fax Number | 2157282773 |
| Mailing Telephone | 2157286900 |
| Mailing Fax Number | 2157282773 |
| Enumeration Date | 2012-03-07 |
| Last Update Date | 2018-06-14 |
| Authorized Official Name | TONYA WOODARD (CREDENTIALING/MANAGER) |
| Authorized Official Telephone | 2157073911 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 1026888280003 | 05 |
| Other Name | Type Code |
|---|---|
| Otolaryn Assoc of FCCC, MGI | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801160981 | Fox Chase Cancer Center Medical Group, Inc | Psychologist | 333 Cottman Ave, Fox Chase Cancer Center, Philadelphia, PA 19111-2434 | 2012-03-07 |
| 1710251897 | Fox Chase Cancer Center Medical Group, Inc | Psychiatry & Neurology | 333 Cottman Ave, Fox Chase Cancer Center, Philadelphia, PA 19111-2434 | 2012-03-07 |
| 1073887154 | Fox Chase Cancer Center Medical Group, Inc | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 333 Cottman Ave, Fox Chase Cancer Center, Philadelphia, PA 19111-2434 | 2012-03-07 |
| 1518231695 | Fox Chase Cancer Center Medical Group, Inc | Surgery | 333 Cottman Ave, Fox Chase Cancer Center, Philadelphia, PA 19111-2434 | 2012-03-07 |
| 1538433610 | Fox Chase Cancer Center Medical Group, Inc | Internal Medicine | 333 Cottman Ave, West Bldg/cru, Philadelphia, PA 19111-2434 | 2012-03-07 |
| 1528332608 | Fox Chase Cancer Center Medical Group, Inc | Radiology | 333 Cottman Ave, Fox Chase Cancer Center, Philadelphia, PA 19111-2434 | 2012-03-07 |
| 1427322502 | Fox Chase Cancer Center Medical Group, Inc | Urology | 333 Cottman Ave, Fox Chase Cancer Center, Philadelphia, PA 19111-2434 | 2012-03-07 |
| 1992079073 | Fox Chase Cancer Center Medical Group, Inc | Internal Medicine | 333 Cottman Ave, Philadelphia, PA 19111-2434 | 2012-03-07 |
| 1447524525 | Fox Chase Cancer Center Medical Group, Inc | Internal Medicine | 333 Cottman Ave, Fox Chase Cancer Center, Philadelphia, PA 19111-2434 | 2012-03-07 |
| 1891069977 | Fox Chase Cancer Center Medical Group, Inc | Internal Medicine | 333 Cottman Ave, Fox Chase Cancer Center, Philadelphia, PA 19111-2434 | 2012-03-07 |
| Street Address |
333 COTTMAN AVE FOX CHASE CANCER CENTER |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19111-2434 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356347504 | Sangeeta K Tyerech | Radiology | 333 Cottman Ave, Philadelphia, PA 19111 | 2005-06-22 |
| 1114524097 | Bernadette Golarz | Nurse Anesthetist, Certified Registered | 333 Cottman Ave, Philadelphia, PA 19111-2434 | 2020-10-05 |
| 1023625878 | Nallely Hernandez | Internal Medicine | 333 Cottman Ave, Philadelphia, PA 19111-2497 | 2020-09-25 |
| 1780298612 | Jean Marie Arlt | Psychologist | 333 Cottman Ave, Philadelphia, PA 19111-2434 | 2020-09-08 |
| 1811500549 | Facundo Iriarte | Surgery | 333 Cottman Ave, Philadelphia, PA 19111-2497 | 2020-08-24 |
| 1275157455 | Temple University Hospital, Inc | General Acute Care Hospital | 333 Cottman Ave, Philadelphia, PA 19111-2434 | 2020-06-03 |
| 1548898836 | Hannah Rosenstein Campbell | Genetic Counselor, MS | 333 Cottman Ave, Philadelphia, PA 19111-2434 | 2020-03-31 |
| 1285281238 | Senthuran Tharmalingam | Surgery | 333 Cottman Ave, Philadelphia, PA 19111-2497 | 2019-08-23 |
| 1619452885 | Max David Lefton | Surgery | 333 Cottman Ave, Philadelphia, PA 19111-2434 | 2018-10-03 |
| 1730669425 | Christopher Mkl Yao | Otolaryngology | 333 Cottman Ave, Philadelphia, PA 19111-2497 | 2018-08-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164036026 | Grace Agency Incorporated | Home Health | 433 Longshore Ave, Philadelphia, PA 19111 | 2020-09-08 |
| 1124517750 | Dana Christine Campetti | Physician Assistant | 700 Cottman Ave Ste 201, Philadelphia, PA 19111 | 2018-05-09 |
| 1235654286 | Dorotea Mutabdzic | Surgery | Fox Chase Cancer Center, 333 Cottman Ave, Dept of Surgical Oncology, Philadelphia, PA 19111 | 2017-08-11 |
| 1952841041 | Personal Care Home C&g | Point of Service | 6176 Newtown Ave, Philadelphia, PA 19111 | 2017-03-08 |
| 1477006849 | Fox Chase Cancer Center | Clinic/Center | 333 Cottman Ave., Philadelphia, PA 19111 | 2016-08-02 |
| 1578927521 | Peter Whooley | Student in an Organized Health Care Education/Training Program | Temple University/fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA 19111 | 2016-04-06 |
| 1043673783 | Matthew Holzerman | Physical Therapy Assistant | 1148 Tabor Plz, Philadelphia, PA 19111 | 2016-03-31 |
| 1831563329 | Aging With Care Inc | Home Health | 1614 Loney St, Philadelphia, PA 19111 | 2015-11-20 |
| 1043687551 | Kenneth Marsaglia II | Preventive Medicine | 8414 Bridle Road, Philadelphia, PA 19111 | 2015-09-01 |
| 1700220514 | Lorraine A Tauriello | Counselor | 716 Ripley St, Philadelphia, PA 19111 | 2013-04-23 |
| Find all providers in zip 19111 | ||||
| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790278372 | Vishaal Patel | Otolaryngology | 3440 N Broad St # 300, Philadelphia, PA 19140-5104 | 2018-06-08 |
| 1033630892 | Jessica Anne Tang | Otolaryngology | 3440 North Broad Street, Kresge West #300, Philadelphia, PA 19140 | 2017-07-03 |
| 1912313792 | Julie Paige Shtraks | Otolaryngology | 205 N Broad St Ste 401, Philadelphia, PA 19107-1553 | 2014-07-01 |
| 1639585417 | Steven A Zuniga Jr. | Otolaryngology | 2201 Pennsylvania Ave Apt 111, Philadelphia, PA 19130-3512 | 2014-07-01 |
| 1952711574 | Anne Morgan Selleck | Otolaryngology | 145 S 13th St Apt 705, Philadelphia, PA 19107-4930 | 2014-05-05 |
| 1245659911 | Kirkland N Lozada | Otolaryngology | 3737 Market St Fl 3, Philadelphia, PA 19104-5545 | 2014-04-10 |
| 1225311798 | Amanda Chia-ming Hu | Otolaryngology | 219 N Broad St Fl 10, Philadelphia Ear Nose & Throat Associates, Philadelphia, PA 19107-1506 | 2011-09-21 |
| 1942471131 | A J Woodring Md Associates | Otolaryngology | 1841 S 15th St, Philadelphia, PA 19145-2301 | 2008-03-17 |
| 1811007487 | Ent R Net Pa | Otolaryngology | 4190 City Line Avenue, Suite 526, Philadelphia, PA 19131-1635 | 2006-08-30 |
| 1750315388 | Edward B Gaynor | Otolaryngology | 1500 North 39th Street, Philadelphia, PA 19104 | 2006-07-10 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19111 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.